Clinical Performance of Endodontically Treated Teeth Restored With Endocrowns and Overlays
Conditions
Keywords
Endocrown, Overlay restoration, Feldspathic ceramic, CAD/CAM dentistry, Retrospective study, Clinical performance, Adhesive dentistry, Plaque index
Brief summary
Observational Study The goal of this observational study is to evaluate the clinical performance and patient satisfaction of endodontically treated teeth restored with endocrown and overlay restorations using feldspathic ceramic blocks over a 2 to 4-year period. The main questions this study aims to answer are: What are the survival rates of endocrown and overlay restorations in posterior teeth after 2 to 4 years? Are there differences in biological and mechanical failure rates between endocrown and overlay restorations? How do the cemented surface areas correlate with clinical outcomes? Participants who previously received endocrown or overlay restorations will undergo a clinical evaluation, including radiographic imaging, to assess secondary caries and restoration integrity. They will also rate their satisfaction with their restorations through a standardized survey. Retrospective STL file analysis will be used to measure cemented surface areas of the restorations.
Detailed description
This retrospective observational study aims to evaluate the clinical performance and patient satisfaction of endocrowns and overlay restorations fabricated from feldspathic ceramic CAD/CAM blocks over a period of 2 to 4 years. The study involves patients treated exclusively at the Private Ortoperio Dental Clinic in Kayseri, Turkey. Endocrowns and overlays are widely used for restoring structurally compromised teeth. Endocrowns provide macro-retention by utilizing the pulp chamber and micro-retention through adhesive cementation, making them particularly suitable for endodontically treated teeth with limited crown height or narrow interocclusal spaces. Overlays, on the other hand, provide minimally invasive coverage while preserving the underlying tooth structure. Despite their popularity, long-term clinical data for these restorations remain limited. The study will include 39 patients, aged between 18 and 75, who previously received endocrown or overlay restorations. Eligible participants must have functioning restorations placed at least 2 years prior, with records of digital impressions (STL files) archived at the clinic. Restorations will be evaluated using modified FDI criteria to assess aesthetic, functional, and biological outcomes. The criteria for failure include ceramic fractures, loosening, dislodgment, secondary caries, and periodontal issues. Patient satisfaction will also be measured using a Likert scale questionnaire. Digital impressions of the cemented teeth will be analyzed using Materialise 3-matic software to calculate cemented surface areas. Additionally, the oral hygiene of participants will be assessed using the plaque index, and the mean plaque index score will be calculated for each patient. Statistical analyses will be conducted to determine potential factors affecting clinical outcomes, with methods to be determined based on data characteristics. This study seeks to fill gaps in the literature by providing robust data on the survival rates and failure mechanisms of feldspathic ceramic endocrown and overlay restorations. Results are expected to guide clinicians in material selection and application techniques for achieving optimal outcomes in similar cases.
Interventions
DIAGNOSTIC_TESTRadiographic Imaging and Digital STL Analysis
This study utilizes radiographic imaging (bitewing radiographs) and digital analysis of archived STL files to evaluate the clinical performance of endocrown and overlay restorations. The STL files are processed using Materialise 3-matic software to calculate cemented surface areas. Radiographic imaging assesses the presence of secondary caries or other failures. These diagnostic methods provide quantitative and visual data to evaluate long-term outcomes of the restorations.
DIAGNOSTIC_TESTFDI Criteria Evaluation and Plaque Index Measurement
This intervention includes the evaluation of dental restorations using modified FDI criteria, assessed on a 5-point Likert scale that measures aesthetic, functional, and biological outcomes. Additionally, oral hygiene is assessed through the measurement of the plaque index, with a mean score calculated for each participant. The use of both FDI-based Likert scoring and plaque index measurements allows for a detailed evaluation of restoration performance and oral health status, combining subjective patient-reported outcomes with objective clinical metrics.
Sponsors
TC Erciyes University
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Participants must have at least one posterior tooth restored with a CEREC posterior restoration (overlay and/or endocrown) during the specified period (January 2019 to September 2022). * The restored tooth must be functional and in normal occlusal relationship. * Participants must have archived intraoral digital impressions (STL files) of the restored teeth.
Exclusion criteria
* Individuals unwilling to cooperate. * Teeth with endocrown or overlay restorations that were extracted. * Participants younger than 18 or older than 75 years. * Individuals with disabilities that could impede participation. * Participants who have moved away or are deceased.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Evaluation of Restorations Using FDI Criteria | 2 to 4 years after the placement of restorations, evaluated between October 3, 2024, and October 17, 2024. | The primary outcome measure involves scoring each restoration based on modified FDI criteria, including aesthetic, functional, and biological parameters. Two independent evaluators assessed each restoration, and a consensus score was recorded on a 5-point Likert scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean Plaque Index Score for Each Participant | Assessed during clinical evaluations conducted between October 3, 2024, and October 17, 2024. | Oral hygiene was assessed for each participant by calculating the mean plaque index score, providing an average value for oral hygiene status. |
| Secondary Caries Evaluation | Evaluated during clinical examinations conducted between October 3, 2024, and October 17, 2024. | Radiographic assessment was performed to detect the presence of secondary caries under or around each restoration, and the findings were documented as part of the clinical evaluation. |
| Cemented Surface Area Measurement | Retrospective analysis conducted on archived STL files in November 2024. | The cemented surface area of each restoration was calculated using STL files and analyzed with Materialise 3-matic software to correlate surface area with clinical outcomes. |
Countries
Turkey (Türkiye)
Outcome results
None listed